Breast Cancer Lewis Testbank

What information should the nurse include service group about breast self-examination (BSE)?

BSE will reduce the risk of dying from breast cancer.

BSE should be done daily while taking a bath or shower.

Annual mammograms should be scheduled in addition to BSE.

Performing BSE after the menstrual period is more comfortable.

Performing BSE after the menstrual period is more comfortable.

Which question is most pertinent for the nurse to ask a 43-yr-old patient about her risk for breast cancer?

Do you currently smoke tobacco

Have you ever had a breast injury

At what age did you start having menstrual periods

Is there a family history of fibrocystic breast changes

At what age did you start having menstrual periods

Early menarche and late menopause are risk factors for breast cancer because of the prolonged exposure to estrogen that occurs. Cigarette smoking, breast trauma, and fibrocystic breast changes are not associated with increased breast cancer risk.

A 51-yr-old patient with a small immobile breast lump is considering having a fine-needle aspiration (FNA) biopsy. What should the nurse explain as an advantage to this procedure?

FNA is done in the outpatient clinic, and results are available in 1 to 2 days.

Only a small incision is needed, resulting in minimal breast pain and scarring.

If the biopsy results are negative, no further diagnostic testing will be needed.

FNA is guided by a mammogram, ensuring that cells are taken from the lesion.

FNA is done in the outpatient clinic, and results are available in 1 to 2 days.

Which assessment finding in a 36-yr-old patient is most indicative of a need for further evaluation?

Bilateral breast nodules that are tender with palpation.

A breast nodule that is 1 cm in size, nontender, and fixed.

A breast lump that increases in size before the menstrual period.

A breast lump that is small and mobile, with a rubbery consistency.

A breast nodule that is 1 cm in size, nontender, and fixed.

Painless and fixed lumps suggest breast cancer. The other findings are more suggestive of benign processes such as fibrocystic breasts and fibroadenoma.

A 53-yr-old woman who is experiencing menopause is discussing the use of hormone therapy (HT) with the nurse. Which information about the risk of breast cancer will the nurse provide?

HT is a safe therapy for menopausal symptoms if there is no family history of BRCA genes.

HT does not appear to increase the risk for breast cancer unless there are other risk factors.

The patient and her health care provider must weigh the benefits of HT against the risks of breast cancer.

Natural herbs are as effective as estrogen in relieving symptoms without increasing

he patient and her health care provider must weigh the benefits of HT against the risks of breast cancer.

Because HT is linked to an increased risk for breast cancer, the patient and health care provider must determine whether to use HT. Breast cancer incidence is increased in women using HT, independent of other risk factors. HT increases the risk for both non􏱍BRCA-associated cancer and BRCA-related cancers. Alternative therapies can be used but are not consistent in relieving menopausal symptoms.

What will the nurse teach a patient with metastatic breast cancer who has a new prescription for trastuzumab (Herceptin)?

Hot flashes may occur with the medication.

Serum electrolyte levels will be drawn monthly.

The patient will need frequent eye examinations.

The patient should call if she notices ankle swelling.

The patient should call if she notices ankle swelling.

Trastuzumab can lead to ventricular dysfunction, so the patient is taught to self-monitor for symptoms of heart failure.

After a 48-yr-old patient has had a modified radical mastectomy, the pathology report identifies the tumor as an estrogen-receptor positive adenocarcinoma. What topic should the nurse plan to teach the patient?

a. Estradiol

b. Tamoxifen

c. Raloxifene

d. Trastuzumab

Tamoxifen is used for estrogen-dependent breast tumors in premenopausal women.

Raloxifene is used to prevent breast cancer, but it is not used postmastectomy to treat breast cancer. Estradiol will increase the growth of estrogen-dependent tumors. Trastuzumab is used to treat tumors that have the HER-2 receptor.

Which nursing action should be included in the plan of care for a patient returning to the surgical unit after a left modified radical mastectomy with dissection of axillary lymph nodes?

Teach the patient to use the ordered patient-controlled analgesia every 10 minutes.

Obtain a permanent breast prosthesis before the patient is discharged from the

hospital.

Post a sign at the bedside warning against venipunctures or blood pressures in the

left arm.

Insist that the patient examine the surgical incision when the initial dressings are

removed.

Post a sign at the bedside warning against venipunctures or blood pressures in the

left arm.

The patient is at risk for lymphedema and infection if blood pressures or venipuncture are done on the left arm. The patient is taught to use the PCA as needed for pain control rather than at a set time. The nurse allows the patient to examine the incision and participate in care when the patient feels ready. Permanent breast prostheses are usually obtained about 6 weeks after surgery.

The nurse provides discharge teaching for a 61-yr-old patient who has had a left modified radical mastectomy and lymph node dissection. Which statement by the patient indicates that teaching has been successful?

I will need to use my right arm and to rest the left one

I will avoid reaching over the stove with my left hand

I will keep my left arm in a sling unti the incision is healed

I will stop the left arm exercises if moving the arm is painful

I will avoid reaching over the stove with my left hand to prevent any injury to the left arm

A patient newly diagnosed with stage I breast cancer is discussing treatment options with the nurse. Which statement by the patient indicates that additional teaching may be needed?

There are several options that I can consider for treating cancer

I

A 36-yr-old patient who has a diagnosis of fibrocystic breast changes calls the nurse in the clinic reporting symptoms. Which information is likely to change the treatment plan?

There is a yellow discharge from the patient's right nipple

An area on the breast is hot, pink, and tender to the touch.

Firm, moveable lumps are in the upper outer breast quadrants.

The lumps get more painful before the patient's menstrual period

An area on the breast is hot, pink, and tender to the touch.

An area that is hot or pink suggests an infectious process such as mastitis which would require further treatment.

Manifestations of fibrocystic breast changes include one or more palpable lumps that are often round, well delineated and freely movable within the breast. Discomfort ranging from tenderness to pain may also occur. The lump may increase in size and tenderness before menstruation. Nipple discharge associated with fibrocystic breasts is often milky, water-milky, yellow or green.

The nurse notes bilateral enlargement of the breasts during examination of a 62-yr-old male patient. Which action should the nurse take first?

Refer the patient for mammography.

Question the patient about current medications.

Explain that this is temporary due to hormonal changes.

Teach the patient how to palpate the breast tissue for lumps.

Question the patient about current medications.

The first action should be further assessment. Because gynecomastia is a possible side effect of drug therapy, asking about the current drug regimen is appropriate. The other actions may be needed, depending on the data that are obtained with further assessment.

The nurse is caring for a patient with breast cancer who is receiving chemotherapy with doxorubicin and cyclophosphamide. Which assessment finding is most important to communicate to the health care provider?

The patient reports fatigue.

The patient eats only 25% of meals.

The patient's apical pulse is irregular

The patient's white blood cell count is 5,000/uL

The patient's apical pulse is irregular

The outpatient clinic receives telephone messages from four patients. Which patient should the nurse call back first?

A 40-yr-old patient who has left side chest and arm pain 2 months after a left

modified radical mastectomy

A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue

A 21-yr-old patient with a family history of breast cancer who wants to discuss

A 57-yr-old patient with ductal ectasia who has sticky multicolored nipple discharge and severe nipple itching

A 50-yr-old patient with stage 2 breast cancer who is receiving doxorubicin and has ankle swelling and fatigue

Although all the patients have needs that the nurse should address, the patient who is receiving a cardiotoxic medication and has symptoms of heart failure should be assessed by the nurse first.

2 multiple choice options